Yıl: 2009 Cilt: 36 Sayı: 2 Sayfa Aralığı: 127 - 133 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Karaciğer sirozunda hemostatik bozukluklar

Öz:
Hemostatik bozukluklar, karaciğer hastalıklarında sık görülebilmekte ve bazen ciddi sonuçlara yol açabilmektedir. Bu çalışmada protrombin zamanı, aktive parsiyel tromboplastin zamanı, fibrinojen, fibrin yıkım ürünleri, faktör 7, 8 ve 9, transferin, haptoglobin, protein C, protein S, antitrombin III ve diğer bazı hematolojik parametrelerin karaciğer hastalığının düzeyi ile ilişkisi araştırılmıştır. Bu sonuçlara bağlı olarak karaciğer sirozlu hastalarda hematolojik bozuklukların ve hemostatik mekanizmalardaki değişikliklerin incelenmesi amaçlanmıştır. Bu çalışmaya karaciğer sirozu tanısı konan 44 hasta alındı. Hastaların 36’sı erkek, 8’i kadındı. Hastaların yaş ortalaması 43.2 yıl (31-76) idi. Spontan bakteriyel peritonit, hepatoselüler karsinoma, hepatorenal sendrom ve kolestatik karaciğer hastalığı olan vakalar çalışmaya alınmadı. Hastalar 4’ü Child A, 20’si Child B, ve 20’si Child C olmak üzere 3 gruba ayrıldı. Yaş ortalaması A grubunda 39, B’de 54, C’de ise 45 yıl idi (p>0.05). Hastaların 40’ında (%90) HBV, 2’sinde HBV+HDV (%5) , 2’sinde ise (%5) alkole bağlı karaciğer sirozu mevcuttu.Gruplar arasında AST, ferritin, haptoglobulin, cinsiyet ve asit varlığı bakımından anlamlı fark mevcuttu (p<0.05). aPTZ, serum demiri ve transferin B ve C gruplarında benzerken, bu gruplar ile A grubu arasında anlamlı olmayan fark vardı (p>0.05). Gruplar arasında protrombin zamanı, faktör 7, 8 ve 9, protein C ve S, antitrombin III, fibrinojen, fibrin yıkım ürünleri, serum demir bağlama kapasitesi, hemoglobin, platelet, lökosit ve ortalama korpüsküler volüm bakımından fark bulunmadı (p>0.05). Sonuç olarak, karaciğer sirozu olan hastalarda hemostatik bozukluklar ile hastalığın aktivitesi ve klinik seyir arasında ilişki olduğu ve bu durumun hastalığın takip ve tedavisinde önemli olduğu söylenebilir.
Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Hematoloji Gastroenteroloji ve Hepatoloji

Hemostatic abnormalities in liver cirrhosis

Öz:
In this study, 44 patients with liver cirrhosis were investigated for hemostatic parameters. Patients with spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatorenal syndrome and cholestatic liver diseases were excluded. Patients were classified by Child-Pugh criterion and according to this 4 patients were in Class A, 20 in Class B and 20 in C. Regarding to these results, it was aimed to investigate the haematological disturbances in liver cirrhotic patients. In the result there was a correlation between activated partial thromboplastin time, serum iron, ferritin, transferrin, haptoglobin and Child-Pugh classification. Besides there was no correlation between prothrombin time, factor 8 and 9, protein C and S, anti-thrombin 3, fibrinogen, fibrin degradation products, serum iron binding capacity, hemoglobin, leukocyte, mean corpuscular volume and Child-Pugh classification. There were significant difference, in terms of AST, ferritin, haptoglobulin, sex and presence of ascites between groups (p<0.05). In all groups there were abnormalities and dysfunctions in prothrombin time, fibrinogen, factor 8 and 9, serum iron, ferritin, transferrin, haptoglobin, protein C and S, anti-thrombin 3, hemoglobin and platelets, where there was no in activated partial thromboplastin time, fibrin degradation products, serum iron binding capacity, leucocytes and mean corpuscular volume (p>0.05).In the summary, we have found correlation between hemostatic abnormalities and disease activity and clinical prognosis in patients with liver cirrhosis which is important in the management of these patients. This is also important for identification of liver transplant candidiates earlier.
Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Hematoloji Gastroenteroloji ve Hepatoloji
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA YALÇIN K, AYYILDIZ M (2009). Karaciğer sirozunda hemostatik bozukluklar. , 127 - 133.
Chicago YALÇIN Kendal,AYYILDIZ MEHMET ORHAN Karaciğer sirozunda hemostatik bozukluklar. (2009): 127 - 133.
MLA YALÇIN Kendal,AYYILDIZ MEHMET ORHAN Karaciğer sirozunda hemostatik bozukluklar. , 2009, ss.127 - 133.
AMA YALÇIN K,AYYILDIZ M Karaciğer sirozunda hemostatik bozukluklar. . 2009; 127 - 133.
Vancouver YALÇIN K,AYYILDIZ M Karaciğer sirozunda hemostatik bozukluklar. . 2009; 127 - 133.
IEEE YALÇIN K,AYYILDIZ M "Karaciğer sirozunda hemostatik bozukluklar." , ss.127 - 133, 2009.
ISNAD YALÇIN, Kendal - AYYILDIZ, MEHMET ORHAN. "Karaciğer sirozunda hemostatik bozukluklar". (2009), 127-133.
APA YALÇIN K, AYYILDIZ M (2009). Karaciğer sirozunda hemostatik bozukluklar. Dicle Tıp Dergisi, 36(2), 127 - 133.
Chicago YALÇIN Kendal,AYYILDIZ MEHMET ORHAN Karaciğer sirozunda hemostatik bozukluklar. Dicle Tıp Dergisi 36, no.2 (2009): 127 - 133.
MLA YALÇIN Kendal,AYYILDIZ MEHMET ORHAN Karaciğer sirozunda hemostatik bozukluklar. Dicle Tıp Dergisi, vol.36, no.2, 2009, ss.127 - 133.
AMA YALÇIN K,AYYILDIZ M Karaciğer sirozunda hemostatik bozukluklar. Dicle Tıp Dergisi. 2009; 36(2): 127 - 133.
Vancouver YALÇIN K,AYYILDIZ M Karaciğer sirozunda hemostatik bozukluklar. Dicle Tıp Dergisi. 2009; 36(2): 127 - 133.
IEEE YALÇIN K,AYYILDIZ M "Karaciğer sirozunda hemostatik bozukluklar." Dicle Tıp Dergisi, 36, ss.127 - 133, 2009.
ISNAD YALÇIN, Kendal - AYYILDIZ, MEHMET ORHAN. "Karaciğer sirozunda hemostatik bozukluklar". Dicle Tıp Dergisi 36/2 (2009), 127-133.